Process utility from providing informal care: the benefit of caring

被引:143
作者
Brouwer, WBF
van Exel, NJA
van den Berg, B
van den Bos, GAM
Koopmanschap, MA
机构
[1] Erasmus Univ, Dept Hlth Policy & Management, NL-3000 DR Rotterdam, Netherlands
[2] Erasmus Univ, Inst Med Technol Assessment, NL-3000 DR Rotterdam, Netherlands
[3] Natl Inst Publ Hlth & Environm, NL-3720 BA Bilthoven, Netherlands
[4] Univ Amsterdam, Acad Med Ctr, Dept Social Med, NL-1012 WX Amsterdam, Netherlands
关键词
informal care; process utility;
D O I
10.1016/j.healthpol.2004.12.008
中图分类号
R19 [保健组织与事业(卫生事业管理)];
学科分类号
摘要
Though economics is usually outcome-oriented, it is often argued that processes matter as well. Utility is not only derived from outcomes, but also from the way this outcome is accomplished. Providing care on a voluntary basis may especially be associated with such process utility. In this paper, we discuss the process utility from providing informal care. We test the hypothesis that informal caregivers derive utility not only from the outcome of informal care, i.e. that the patient is adequately cared for, but also from the process of providing informal care. We present empirical evidence of process utility on the basis of a large sample of Dutch caregivers (n = 950). We measure process utility as the difference in happiness between the current situation in which the care recipient is cared for by the caregiver and the hypothetical situation that someone else takes over the care tasks, all other things equal. Other background characteristics on patient and caregiver characteristics, objective and subjective caregiver burden and quality of life are also presented and related to process utility. Our results show that process utility exists and is substantial and therefore important in the context of informal care. Almost half of the caregivers (48.2%) derive positive utility from informal care and on average happiness would decline if informal care tasks were handed over to someone else. Multivariate regression analysis shows that process utility especially relates to caregiver characteristics (age, gender, general happiness, relation to patient and difficulties in performing daily activities) and subjective caregiver burden, whereas it also depends on the number of hours of care provided (objective burden). These results strengthen the idea of supporting the use of informal care, but also that of keeping a close eye on the position of carers. (c) 2004 Elsevier Ireland Ltd. All rights reserved.
引用
收藏
页码:85 / 99
页数:15
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